Healthcare Provider Details

I. General information

NPI: 1457315020
Provider Name (Legal Business Name): GEORGETOWN WOMEN'S CENTER, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 SCENIC DR SUITE 204
GEORGETOWN TX
78626-7726
US

IV. Provider business mailing address

PO BOX 917
GEORGETOWN TX
78627-0917
US

V. Phone/Fax

Practice location:
  • Phone: 512-863-6850
  • Fax: 512-869-1788
Mailing address:
  • Phone: 512-863-6850
  • Fax: 512-869-1788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREW GLENN MAHAFFEY
Title or Position: M.D./ PRESIDENT
Credential: M.D.
Phone: 512-863-6850